Journal of Oral Pathology & Medicine最新文献

Objective: This study aimed to develop and evaluate Machine Learning models to predict the malignant transformation (MT) in patients with actinic cheilitis (AC).

Methods: Three hundred forty patients diagnosed with AC (322 in the no MT group, and 18 in the MT group) were carefully documented. The study used the Adaptive Synthetic Sampling to adaptively balance the dataset (322 in the no MT group and 319 in the MT group). Four supervised Machine Learning classifiers (Random Forest, Xtreme Gradient Boosting, Multilayer Perceptron, and Support Vector Machine) were trained and tested using 5-fold cross-validation to correlate inputs (clinical descriptors and demographic data) to outputs (MT). SHAP values were used to identify the most influential predictors of MT.

Results: The Xtreme Gradient Boosting model stood out, achieving 96.72% accuracy, 96.87% sensitivity, 96.57% specificity, 96.61% precision, 96.73% of F1-Score, and 0.9498 AUC. Multilayer Perceptron showed the best sensitivity (98.44%), and Random Forest presented comparable results. In contrast, Support Vector Machine underperformed, with higher values of false negatives and false positives. Across models, ulceration, multifocality, and long-standing lesions were the strongest predictors of MT, while small, asymptomatic, or solitary lesions were associated with lower risk.

Conclusion: The results revealed promising performance metrics for Xtreme Gradient Boosting and Multilayer Perceptron suggesting their potential value as tools in a support system for monitoring AC. Additionally, synthetic data proved constructive in training, enhancing the models' robustness and predictive capabilities.

Importance: Diprosopus is an exceedingly rare craniomaxillofacial dysmorphosis that is considered a subgroup of conjoined twins. This phenotype encompasses a broad spectrum of duplications ranging from partial structures to complete dicephalus. The embryogenesis and mechanism of disease are not well understood. The objective of this investigation was to describe a case of partial dentofacial duplication and to discuss the possible etiology with novel genetic insights thereof.

Observations: A newborn Kazakh boy was referred to the First Affiliated Hospital of Xinjiang Medical University because of a maxillary mass detected on prenatal imaging. Physical examination revealed a unilateral cleft lip and a soft lump around 2.5 cm in diameter with the appearance of an accessory upper lip. He underwent two surgical procedures at 11 months and 4 years of age for definitive treatment. He demonstrated favorable recovery outcomes, maintaining normal speech and oral intake capabilities during long-term follow-up.

Conclusions and relevance: Our preliminary findings and comprehensive literature review suggest that mutations in the PAX7 gene could contribute to the pathogenesis of craniofacial duplication. This hypothesis establishes a previously unrecognized association between specific genetic alterations and the clinical manifestations of this condition, potentially offering a molecular foundation for prenatal diagnostic approaches. The present case provides more profound insights into the disease mechanisms compared to prior reports. Further validation through basic scientific investigations and clinical studies, incorporating comprehensive genetic analyses, will be essential to substantiate this proposed mechanism.

Background: No studies to date have examined human papillomavirus (HPV) positivity in both odontogenic keratocysts (OKCs) and dentigerous cysts (DCs) or performed HPV genotyping in these lesions. This research aims to compare HPV expression rates in DCs and OKCs to provide insight into the molecular behavior of OKCs.

Methods: Forty DC and forty OKC cases were randomly selected and analyzed for HPV-DNA expression. Positive cases underwent HPV genotyping. Additionally an immunohistochemical staining for p16 was performed for each case.

Results: Due to epithelial integrity loss or inflammation, 18 samples were excluded, leaving 32 DCs and 30 OKCs for evaluation. HPV was detected in five DC cases but absent in all OKC samples. The difference between DC and OKC groups was not statistically significant (p = 0.053). Genotyping identified HPV-16 in four cases and HPV-66 in one.

Discussion: Despite OKCs' aggressive behavior, this study found no significant association between HPV and their pathogenesis. These findings suggest HPV is unlikely to contribute to OKC proliferation or recurrence, underscoring the need for larger studies to clarify its role in odontogenic cysts.

Background: The dynamic interplay between reactive free radicals (FR) and antioxidants (AO) can lead to either redox homeostasis or oxidative stress. Disruption of redox balance contributes to oxidative stress, a key factor in the pathogenesis of various conditions, notably oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC). At low to moderate levels, FRs trigger adaptive mutations that initiate carcinogenesis and support neoplastic cell survival. In contrast, high concentrations of FRs exert cytotoxic effects, a mechanism exploited in radiotherapy and chemotherapy. Antioxidants counteract FRs, mitigating cellular damage-a benefit demonstrated in several clinical trials involving OPMDs. However, their efficacy in OSCC remains contentious.

Methods and finding: This review explores the multifaceted roles of FRs and AOs in OPMD and OSCC, with emphasis on their contributions to carcinogenesis and therapeutic strategies. Tracking the FR-AO ratio during treatment may offer predictive insights into malignant transformation and facilitate early OSCC detection.

Background: Mast cells are believed to contribute to inflammation-associated carcinogenesis, but their specific role in the development of oral leukoplakia (OLK) and its progression to oral squamous cell carcinoma (OSCC) remains uncertain. This systematic review and meta-analysis aimed to determine whether mast cell density differs among normal oral mucosa (NOM), OLK, and OSCC.

Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science and Embase along with Google Scholar for studies that reported mast cell counts in OLK, OSCC, and NOM published up to September 30, 2025. Data were extracted, and the mean difference was calculated. Risk of bias was assessed using the JBI critical appraisal tool, and meta-analysis was performed using MetaAnalysisOnline.com.

Results: Thirty-four studies were included for qualitative and 26 contributed to quantitative data synthesis. The studies opined that mast cells were highest in OSCC, followed by OLK and NOM. Mast cell density was higher in OSCC than in OLK; however, the difference was not significant. A random-effects model revealed a significant increase in mast cell density in OLK than NOM (p < 0.0001) and OSCC than NOM (p = 0.0055); however, when OLK was compared with OSCC, the difference was not significant (p = 0.2865).

Conclusion: The existing data validate that mast cells were increased in oral leukoplakia, indicating their potential involvement in early oral carcinogenesis; however, future studies focusing on the prognostic value of mast cells in oral leukoplakia are warranted.

Trial registration: PROSPERO number: CRD42024533723.

Objective: Head and Neck Squamous Cell Carcinoma (HNSCC) is one of the most common cancers worldwide and has a significant impact on the lives of patients. This study aimed to examine the role and significance of Chromodomain Helicase/ATPase DNA Binding protein 1-Like (CHD1L) in HNSCC.

Methods: CHD1L expression was analyzed using the Cancer Genome Atlas (TCGA-HNSCC) dataset, along with the clinical and clinicopathological features of HNSCC. Additionally, CHD1L mRNA expression was quantified using real-time quantitative PCR (RT-qPCR). The survival rate of patients with HNSCC was assessed using Kaplan-Meier analysis. Furthermore, in silico tools were employed to investigate CHD1L protein networks and functional pathways involved in HNSCC development.

Results: mRNA and protein expression studies, along with in vitro and in silico analyses, confirmed that CHD1L expression was significantly higher in HNSCC tissues than in normal tissues. Clinicopathological analysis revealed associations between CHD1L expression and HPV status, nodal metastasis, disease stage, and tumor grade. Elevated CHD1L levels are also associated with poor patient survival. Functional enrichment analysis showed that CHD1L was associated with HNSCC progression.

Conclusion: CHD1L is significantly upregulated in HNSCC and associated with poor survival outcomes. This suggests that CHD1L may serve as a potential therapeutic target and prognostic marker for HNSCC. Further research is necessary to explore the functional role of CHD1L in the development and progression of HNSCC.

Background: The cardiometabolic burden of oral candidiasis (OC) is yet to be thoroughly elucidated.

Objective: To assess the risk of long-term cardiovascular and metabolic outcomes in patients with OC relative to those with two other common oral conditions: herpes simplex virus (HSV) infections and recurrent aphthous stomatitis (RAS).

Methods: A global retrospective cohort study comprised two analyses comparing patients with OC to those with HSV and RAS. The study groups were compared regarding the risk of 11 different cardiovascular and four metabolic outcomes. Propensity score matching was performed to optimize inter-group comparability.

Results: Relative to those with HSV infections, patients with OC were found to experience a higher risk of stroke (HR, 1.78; 95% CI, 1.65-1.92), sudden cardiac death (HR, 2.46; 95% CI, 2.14-2.82), congestive heart failure (CHF; HR, 1.92; 95% CI, 1.80-2.06), hypertension (HR, 1.56; 95% CI, 1.50-1.62), hyperlipidemia (HR, 1.18; 95% CI, 1.13-1.24), type-2 diabetes mellitus (DM; HR, 1.72; 95% CI, 1.63-1.81), and obesity (HR, 1.32; 95% CI, 1.27-1.38). Compared to RAS, OC demonstrated an elevated risk of myocardial infarction (HR, 1.47; 95% CI, 1.40-1.54), stroke (HR, 1.30; 95% CI, 1.25-1.36), pulmonary embolism (HR, 2.23; 95% CI, 2.11-2.35), peripheral vascular disease (HR, 1.35; 95% CI, 1.29-1.41), atrial fibrillation (HR, 1.61; 95% CI, 1.55-1.68), CHF (HR, 1.79; 95% CI, 1.73-1.86), hyperlipidemia (HR, 1.36; 95% CI, 1.33-1.40), DM (HR, 1.44; 95% CI, 1.40-1.48), and obesity (HR, 1.30; 95% CI,1.27-1.34).

Conclusion: OC is associated with an elevated risk of cardiometabolic outcomes. Physicians managing patients with OC should be aware of these associations.

Background: Oral submucous fibrosis is a potentially malignant disorder with a high malignant transformation rate. Areca nut, being the chief etiologic factor, when chewed, is known to be swallowed and absorbed into circulation resulting in several systemic effects. This is the first kind of report presenting serum organ-specific fibrosis biomarkers suggestive of functional and fibrotic changes in the visceral organs.

Methods: Various fibrotic biomarkers such as kidney injury molecule-1 (KIM-1), alanine aminotransferace (ALT), aspartate aminotransferase (AST), and its ratio to platelet index (APRI), suppression of tumorigenicity-2 (ST2), Krebs von den Lungen-6 (KL-6) and von Willebrand factor (vWF) were analyzed.

Results: The present study evaluated potential systemic fibrotic involvement, modest elevations in ST2 and KL-6 levels in advanced OSF compared to early cases; however, all values remained within normal physiological limits. No significant differences were found between the OSF and healthy groups across all biomarkers. There was no renal involvement, no significant association between liver fibrosis and its systemic biomarkers, and there was minimal vascular involvement. Collectively, these findings support the hypothesis that OSF may be a localized fibrotic disorder with no detectable systemic biomarker alterations in its early to moderate stages.

Conclusions: This study provides an important step in bridging localized oral pathology and systemic disease monitoring. No significant systemic fibrosis was observed but methodology, findings, and recommendations offer a strong basis for future research. Despite the presence of evidence that favors a localized disease model for OSF in its early and advanced stages, systemic monitoring in future clinical paradigms is acknowledged.

Background: Papilliferous keratoameloblastoma (PKA) is an exceptionally rare variant of conventional ameloblastoma, marked by papilliferous epithelial projections and prominent keratinization within an ameloblastomatous framework. Because of its rarity and overlap with other keratinizing odontogenic tumours, PKA is often overlooked and is not recognised in the current WHO classification. Limited awareness and inconsistent terminology contribute to diagnostic uncertainty and may affect clinical management.

Objectives: This review critically analysed all published PKA cases to describe their clinical, radiographic and histopathological features, evaluating whether PKA should be regarded as a distinct clinicopathological entity or a histological subtype of conventional ameloblastoma.

Materials and methods: A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was performed to identify all English-language reports of PKA. Extracted data included demographics, clinical presentation, radiographic findings, histopathology, treatment and outcomes. The information was synthesised and descriptively analysed.

Results: Seven cases of PKA were included. Patients ranged from 18 to 76 years (mean age: 50.4 years), with a male predominance. All lesions involved the right mandible. Clinically, most patients presented with slow-growing mandibular swellings, occasionally accompanied by pain or mucosal changes. Radiographs most often show multilocular radiolucencies with buccolingual expansion or cortical perforation. Histopathology consistently reveals classic ameloblastomatous epithelium with squamous metaplasia, keratin pearl formation, and distinctive papilliferous projections lining cystic spaces.

Conclusion: The uniform histopathological pattern observed across reported cases supports recognising PKA as a distinct histopathological subtype of conventional ameloblastoma. Its formal inclusion in odontogenic tumour classification appears justified, although further molecular and clinicopathological studies are needed to better define its biological behaviour.